In an Aug. 5, 2014 photo, A biker rides a Yamaha motorcycle past a line of parked Harley-Davidson bikes while finding a place to park at the Sturgis motorcycle rally in Sturgis, S.D. (Photo: Eric Ginnard AP)

Drivers of the Budweiser Clydesdale horses take a quick break before heading down the street to kick-off the Annual Mayor's Ride during the 74th Annual Motorcycle Rally on Monday, Aug. 4, 2014. Organizers expect attendance at this week's Sturgis Motorcycle Rally to top the estimated 466,000 who made the annual trek last year. The 74th rally starts Monday and runs through Sunday. (AP Photo/Toby Brusseau) (Photo: Toby Brusseau AP)

Riders flood the streets of Sturgis, S.D., for the opening day of the 74th Annual Motorcycle Rally on Monday, Aug. 4, 2014. Organizers expect attendance at this week's Sturgis Motorcycle Rally to top the estimated 466,000 who made the annual trek last year. The 74th rally starts Monday and runs through Sunday. (AP Photo/Toby Brusseau) (Photo: Toby Brusseau AP)

Riders flood the streets of Sturgis, S.D., for the opening day of the 74th Annual Motorcycle Rally on Monday morning, Aug. 4, 2014. Organizers expect attendance at this week's Sturgis Motorcycle Rally to top the estimated 466,000 who made the annual trek last year. The 74th rally starts Monday and runs through Sunday. (AP Photo/Toby Brusseau) (Photo: Toby Brusseau AP)

Riders flood the streets of Sturgis, S.D., for the opening day of the 74th Annual Motorcycle Rally on Monday, Aug. 4, 2014. Organizers expect attendance at this week's Sturgis Motorcycle Rally to top the estimated 466,000 who made the annual trek last year. The 74th rally starts Monday and runs through Sunday. (AP Photo/Toby Brusseau) (Photo: Toby Brusseau AP)

Lance Armstrong, right, leads a group of motorcyclists outside of Sturgis, S..D for the Annual Mayor's Ride during the 74th Annual Motorcycle Rally, on Monday, Aug. 4, 2014. Organizers expect attendance at this week's Sturgis Motorcycle Rally to top the estimated 466,000 who made the annual trek last year. The 74th rally starts Monday and runs through Sunday. (AP Photo/Toby Brusseau) (Photo: Toby Brusseau AP)

The city streets of Sturgis are lined with motorcycles days before the official kickoff of the 74th Annual Sturgis Motorcycle Rally in Sturgis, S.D, on Friday afternoon, August 1, 2014. (Photo: Toby Brusseau AP)

"Bear" Adams, of Daytona Beach, Fla., waits to card patrons of The Dungeon Bar, days before the official kickoff of the 74th Annual Sturgis Motorcycle Rally in Sturgis, S.D, on Friday, August 1, 2014. (Photo: Toby Brusseau AP)

Emergency responders and hospitals are preparing for the increase in emergency calls that the Sturgis Motorcycle Rally historically brings to the area during the weeklong event.

The event can cause emergency calls to quadruple and reach more than 20 a day, the Rapid City Journal reported Sunday.

To counter the projected increase in calls, emergency workers have already picked up extra shifts to treat such things as shattered bones, strokes and inebriation, and local hospitals have beefed up their staff and limited vacations.

"We see everything; every year is different," said Sturgis Ambulance Director Shawn Fischer. "Last year was a medical year. The year before was a trauma year."

A Nebraska man was killed Friday in an accident on Highway 44 when his bike left the road, making him the first to die in this year's extended rally period. Last year, six people died on area highways during rally time.

The South Dakota Highway Patrol and Sturgis Police Department plan to add several extra officers to respond to accidents, deal with crowds and address parking issues, among other things.

Regional Health officials have added 30 people to work each day in Rapid City during the rally. They expect to spend about $100,000 per day in additional operating costs during the event.

The newspaper reported that as the ridership continues to age, rallygoers are often treated for heart attacks, diabetes, strokes and dehydration as much as road rash or other bodily injuries. The most seriously injured or ill are either airlifted or taken by ambulance to a Rapid City hospital.

"We've kinda seen that the first Monday of the rally sometimes is one of our busiest days," said Lynn Simons, a nurse supervisor at Sturgis Regional Hospital. "Thursday sometimes (is one of) the worst injury days. It's started to be known as 'Black Thursday.'"